Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.
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are found manifested in women who have already presented other symptoms of hysteria, and they almost invariably coincide with other muscular hyperesthesia. The emotions also exert very great influence over them; while rheumatic muscular pains usually appear in women who have already suffered from mus- cular rheumatism, and are in degree exasperated under the influ- ence of emotion. The difficulty in this diagnosis is the greatest, where the patient is both hysterical and rheumatic, which I have often found. But then the influence, or rather inefficiency, of the means, which so usually succeed in the simple hysterical myosalgia, is sufficient to determine the complication of the rheumatic character of the affection in that given case. Two important points still remain in respect to mclyalgic pains. First, does it arise from any inflammatory action, or from mere perversion of muscular sensibility ? or, rather, from a morbid sensibility of the motor nerve filaments that ramify mus- cle fibres ? Leaving the flood of opinions written upon this sub- ject, we will simply answer by the effects of treatment. Mcly- algic pains are no ways relieved, much less broken up, by anti- phlogistic remedies, only yielding temporarily or capriciously to narcotics, and can usually only be relieved by such special means as have no favorable effect upon inflammation. Second, is this pain a muscular neuralgia ? This, at first, is a very natural supposition, but it is in fact unfounded. True muscular neu- ralgias act exactly as do the pains of nerve trunks, and are in- deed very rare in the uncomplicated hysterical. Numerous differences mark this affection of the muscle nerves or muscle tissues, as you may choose to term it, from an exquisitely morbid or exalted sensibility of the skin nerves, which latter, besides other points, it is to be particularly observed, manifest the pains at the periphery of the nerves, but not in the intermediate por- tion ; while in true hyperaesthesia of muscles the pain is felt, and can also be produced by pressure along the entire course of the fibres of the affected muscles. In this latter, pain is only felt at the part compressed; while in neuralgia it can be induced by pressure on certain points, and it then radiates along the course of the branches of the affected nerve. But the best test